the refusal built into the chart
he was offered I.V.-Demerol for the pain of his gunshot wound immediately on admission to the E.R. and has been offered Demerol twice by shift-Drs. who haven’t bothered to read the HISTORY OF NARCOTICS DEPENDENCY NO SCHEDULE C-IV + MEDIC. that Gately’d made Pat Montesian swear she’d make them put in italics on his file or chart or whatever, first thing.
Context
The sobriety test set up before the crisis even arrives, as a bulwark Gately built into the paperwork: knowing what a gunshot wound would be offered, he had the refusal written into his own chart in italics, so the narcotics would be pre-declined by a document rather than by a man in agony who might not trust himself. The recovering addict's foresight is to remove the choice from the moment of maximum pain — and the hospital keeps offering the Demerol anyway, so the choice keeps landing on him regardless.